Abstract

The popularisation of smallpox vaccination from 1798 appeared to offer the opportunity to check the spread of one of the world’s most feared infectious diseases, and the global dissemination of this new technology was rapid. Despite its popularity, vaccination also stimulated significant resistance, for a wide variety of reasons. This thesis is both a social and political history of the responses to vaccination in the eastern Australian colonies of New South Wales, Victoria and Tasmania, from the first Compulsory Vaccination Act in 1853 to Federation in 1901. Despite many cultural, geographical and ideological similarities, each colony followed a different course: Victoria both enacted and enforced compulsory vaccination; Tasmania passed, but failed to consistently enforce, similar legislation; and New South Wales never imposed compulsory vaccination.
This work situates responses to vaccination and its compulsion within a broader framework of colonial perceptions of and experiences with smallpox, vaccine technology, and developments within the state, medicine and society. The colonies derived a great deal of natural protection from their geographical situation, and smallpox was never endemic to Australia, yet it was nevertheless considered a serious and preventable threat. No single factor can explain the different prophylactic strategies pursued by the colonies, and instead a wide range of influences must be assessed in their specific historical context to render these differences explicable. This highlights the significance of smallpox and vaccination in contributing to the development of national identity and the growth of expert bureaucratic structures.
As the first state-sanctioned and subsidised medical procedure aimed at every single member of society, vaccination offered an important contribution to the contemporary processes of the professionalisation of medicine and the medicalisation of society. These processes are crucial to understanding medical responses to vaccination, even as vaccine technology, scientific theories of disease, and public opinion developed and changed. Public responses ranged from pro- to anti-vaccinationism, but the majority of people fell between these two extremes, altering their support over time in accordance with individual assessments of risk versus benefit. Issues of citizenship, political ideology, and expertise informed these decisions.
The roles of, and relationships between, the state, the medical profession and the public both informed and were affected by the vaccination debate, as these groups negotiated the limits of state intervention, individual liberty, and medical expertise in relation to public health. Although Victoria and Tasmania introduced conscientious objection clauses, effectively repealing compulsion, the issues raised by vaccination continued to resonate within wider political and social debates.